Facial Emotion Recognition, Misattribution, and Response Time in Schizophrenia and Bipolar Disorder

Social cognition abilities are significantly impaired in serious mental illnesses. Facial emotion recognition deficits (FERD) have been consistently reported in schizophrenia (SCZ), while the respective findings in bipolar disorder (BPD) are mixed. Assessment of FERD using a task that imposes a time restriction on the stimulus presentation and response may be more akin to real-life situations. We examined FERD, misattribution patterns, and response times in SCZ (n=24) and BPD (n=26) patients and healthy controls (HC; n=26) on: (i) a conventional emotion recognition task using a forced-choice response task, and (ii) a computerized task with the time-restricted presentation of stimuli and recording of the response times. Patients with BPD had a lower duration of illness compared to SCZ patients. Both SCZ and BPD groups showed significantly lower emotion recognition accuracy scores in both tasks, as compared to the HC. The BPD group had significantly higher overidentification than the HC one. On imposing the time restriction, both patient groups gave a significantly higher percentage of the erroneous responses. There were no significant differences in the reaction times. The ratio of accuracy scores vs. response time showed a differential pattern, with a significantly lower ratio for fear in SCZ and that for anger in BPD. The BPD group showed FERDs comparable to those in SCZ patients though the duration of illness in the former was shorter than that in the latter. The study highlights the need for early initiation of the social cognition intervention in patients with serious mental illnesses.